title: Pre-dialysis chronic kidney disease in children: results of a nationwide survey in Japan.
abstract: BACKGROUND
  Chronic kidney disease (CKD) in children is a progressive and intractable condition that may severely impair the child's growth, development and quality of life. Epidemiological information on pediatric CKD, particularly in Asians, is scant.
  
  
  METHODS
  We conducted a nationwide, population-based survey of Japanese children aged 3 months to 15 years with pre-dialysis CKD to examine the prevalence of pediatric CKD in Japan. CKD was classified according to newly established criteria derived from reference serum creatinine levels in Japanese children. Surveys were sent to 1190 institutions across Japan to report on cases of pediatric CKD managed as of 1 April 2010.
  
  
  RESULTS
  A total of 925 institutions (77.7%) responded. Information on 447 children was collected. When subdivided according to our diagnostic criteria, 70.5% of children had stage 3 CKD, 23.9% stage 4 and 5.6% stage 5. The estimated prevalence of Japanese children with CKD was 2.98 cases/100,000 children. Of 407 CKD cases with non-glomerular disease, 278 (68.3%) had congenital anomalies of the kidney and urinary tract (CAKUT). The newly established criteria showed good validity compared with existing criteria, including the abbreviated Schwartz equation.
  
  
  CONCLUSIONS
  Findings from the first nationwide survey of pre-dialysis CKD in Asian children indicate that the prevalence of stage 3-5 CKD in children in Japan aged 3 months to 15 years is 2.98 cases/100,000 children. Most children with CKD presented with non-glomerular disease, most frequently CAKUT. Improved management of CAKUT, including renoprotective treatment and urological intervention, is required.
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishikura
authors.forename: Osamu
authors.initials: O
authors.lastname: Uemura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ito
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wada
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hamasaki
authors.forename: Ryojiro
authors.initials: R
authors.lastname: Tanaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Kaneko
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000151:congenital / Q000453:epidemiology* / Q000209:etiology; D007677:Kidney Function Tests; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D014570:Urologic Diseases / Q000151:congenital / Q000453:epidemiology* / Q000209:etiology
chemical_list: D003404:Creatinine
keywords: Japan; child; creatinine; epidemiology; kidney diseases